Meta-analysis of preoperative estrogen reducing re-adhesion after intrauterine adhesion separation
Objective To evaluate the preventive effect of estrogen pretreatment on intrauterine adhesion(IUA)after hysteroscopic adhesiolysis.Method A systematic search was perfomed in CNKI,Wanfang,VIP,CBM,Pubmed,Cochrane Library,Embase,and the Web of Science databases from the establishment of the repository to April 2023 to collect studies about pretreatment with estrogen prior to uterine adhesions.According to the criteria of inclusion and exclusion,literature selection,data extraction,quality evaluation,etc.Meta analysis was performed using RevMan 5.3 and STATA 14.0 software.Results 11 papers were eventually included.Meta analy-sis results showed menstruation recovery[RR=1.31,95%CI(1.16～1.47),P<0.000 01],uterine morphology recovery[RR=1.39,95%CI(1.20～1.61),P<0.000 1],Fertility outcomes[RR=1.18,95%CI(1.04～1.35),P<0.05],and significantly improved endo-metrium thickness[WMD=0.95,95%CI(0.71～1.2),P<0.000 1],the arteria uterinal blood parameters RI[WMD=-0.08,95%CI(-0.10～-0.06),P<0.000 01]and PI[WMD=-0.18,95%CI(-0.24～-0.12),P<0.000 1]were better than the control group,and the difference was statistically significant.Conclusion Patients with intrauterine adhesions,especially the severe,preoperative oral es-trogen,have a certain preventive effect on postoperative re-adhesion and improve fertility outcomes.
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